# Role of Anti-coagulation in Lemierre's Syndrome With Empyema

**Authors:** Lwin Paing, Khalid Shahzad, Thin Hlaing, Thi Htwe, Saquib Siddiqui

PMC · DOI: 10.7759/cureus.92256 · 2025-09-14

## TL;DR

This case study describes a rare instance of Lemierre's syndrome with empyema and the successful treatment approach involving antibiotics and anti-coagulation.

## Contribution

The novelty lies in highlighting the role of anti-coagulation in managing Lemierre's syndrome with thoracic complications.

## Key findings

- The patient showed clinical improvement with normalized inflammatory markers and resolved radiological effusion.
- A six-week antibiotic course and transition to rivaroxaban were effective in the patient's recovery.

## Abstract

Lemierre's syndrome (LS) is a rare and potentially life-threatening condition that arises as a complication of oropharyngeal infections, characterized by internal jugular vein thrombosis and septicemia. This report describes a rare case of a 26-year-old previously healthy man with typical manifestations mentioned above and additionally with empyema. Management approach was multidisciplinary inputs comprised of antibiotics and surgical measures including anti-coagulation under a specialist’s opinion; nonetheless, it has been a debated issue. The patient improved clinically with normalization of inflammatory markers and radiological resolution of the effusion. He was discharged with a six-week antibiotic course and transitioned to rivaroxaban. This case highlights the importance of early recognition and multidisciplinary management of LS with thoracic complications.

## Linked entities

- **Chemicals:** rivaroxaban (PubChem CID 6433119)
- **Diseases:** empyema (MONDO:0005242)

## Full-text entities

- **Diseases:** jugular vein thrombosis (MESH:D012170), inflammatory (MESH:D007249), septicemia (MESH:D018805), LS (MESH:D057831), effusion (MESH:D000080324), Empyema (MESH:D004653), oropharyngeal infections (MESH:D009959), complications (MESH:D008107)
- **Chemicals:** rivaroxaban (MESH:D000069552)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12519097/full.md

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Source: https://tomesphere.com/paper/PMC12519097